Surgical dressing



Patented Aug. 23, 1938 UNITED- STATES PATENT OFFICE SURGICAL nmtssnao Walter Dahmen, Pelham, N. Y.

' No Drawing.

Application October 28, 1935, Serial No. 47,122

2 Claims. (01. 12s- -90) This invention relates to surgical appliances and more particularly to surgical bandage or dressing that may be used for the treatment of fractures, deformations, enlargements or disloca- 5 tions of bones or joints of an animal or human being. In its more specific aspect the invention is directed to a novel type of dressing or bandage bandages are saturated with water and then applied to the injured part by winding the same thereabout. A dressing or cast of plaster of Paris sets in about thirty minutes and hardens in about twenty-four hours.

Experience has shown that plaster 'of Paris dressing or casts have not been satisfactory in a number of instances, and have the following dis advantages:

When plaster of Paris casts are employed the fragments must be reduced before the application of the plaster of Paris bandage and there is a high probability of disturbing the reduced fragments while applying the cast.

The dressing is generally thick and heavy. There is only a limited possibility of seeing anything definite about the position of the fragments protected by a plaster of Paris dressing when subjecting the same to a fluoroscopic examination; and in some cases when subjected to a radiographic examination definite information as to 40 the position of the fragments is not obtainable and it is entirely impossible to see callous forma-; tion in the early stages.

In case of fractures of the greater trochanter, of upper femur and of the pelvis, it is practically impossible to get satisfactory radiographs taken through a heavy cast.

When an open wound is beneath the cast it is a diflicult and tedious undertaking to cut out a window in said cast so that the wound may be treated.

The removal of a heavy cast requires about an hour of hard and tedious manual labor- It is with a view towards obviating or reducing these disadvantages that my invention has been made. Briefly my invention consists in the provision of a bandage or dressing for-providing a novel dressing or cast which may be relatively thin, relatively light, hasa high X-ray translucency factor, and, in addition, with my novel cast,

so fragment reduction may be accomplished after the cast has been applied, but before it has completely hardened. It consists of a fabric impregnated with a filler and a binder which also acts as a stiffener. An adhesive may be incorporated therewith, which adhesive also serves as a binder. A relatively slow drier may be incorporated therewith so as to promote a more uniform drying throughout the thickness of the cast and a fireproofer may be also incorporated therewith. This composition is carried by a fabricated material such as cheese-cloth, muslin, netting or the like.

An object of my invention is'to provide a dress- 7 ing or cast for fractures or the like which dressing has a relative y high translucency factor to X-rays.

Another object of my invention is to provide a dressing which is relatively light in weight.

Another object of my invention is to provide a cast or dressing which will be suiiiciently flexible so that fragment reduction may be accomplished when the dressing or cast is initially applied and will so harden thereafter as to prevent deleterious movement of the fragments. Another object of my invention is to provide a dressing or cast in which-a window may be readily made and which may be removed with a reasonable amount of effort. 1

Another object of my invention is to provide a dressing which when wrapped will provide a dressing or cast which will have a high transluceney factor to X-rays.

Another object of my invention is to provide a dressing which when wrapped will provide a dressing or cast which will be sufficiently flexible when initially applied sothat fracture reduction maybe accomplished at that time, but which dressing will become sufficiently hardened to prevent fracture displacement. 1

These and other objects of my invention will be Y readily appreciated from the following descrip' tion. According to my invention I have provided a surgical dressing which includes the combination I of a base and a composition which has a relatively high translucency factor to X-rays. The base may comprise a felted, reticular or other like fabric such as gauze or the like, and it may be composed of cotton, linen, or otherlike material which may be readily wrapped or wound.

The composition is preferably of a plastic nature so that it, together with the base, may be capable of being formed or molded around those parts of the body to be protected" upon application of the same. The composition should be plastic upon initial application of the dressing and for a limited time hereafter so that the same may be applied to a fracture and is thereafter flexible enough so that reduction thereof may be accomplished with the dressing thereon, but will set and harden within a reasonable period of time is to serve'as the body of the dressing when it has been applied and set. The flller'should have specific ge Parts Parts Pine wood flour .20 18-22 Cellul i 16 13-18 Gum emf-in ,10 4-10 Castor ml 4' 2-5 CaCl. 1 0. 5-2 Aeatnnn 48 20-50 Cl. w 20 18-81 Absolute CjH OH 12 4-17 thecharacteristic of a high translucency or transparency factor to X-rays. By a high trans- 'lucency or transparency factor to X-rays, I mean that its capacity to X-rays is low or that a unit thickness of the same will'absorb a materially less percentage of X-rays than will a unit thickness of other material, such as plaster of Paris, heretofore employed as the basic composition carried by a surgical dressing. I prefer that the filler be highly comminuted and of a fine flour like consistency. One of the specific fillersthat I have found particularly amenable for my purposes is pine, although oak has been used with success, as have been asbestos, Bakelite and aluminum.

In the dressing when'set or hardened there is a binder which locks the fine particles of filler to each other. The binder may be of any suitable composition which has a high translucency factor to X-rays, which is rigid in short lengths, which is soluble in a volatile solvent and which is relatively light in weight. For this purpose I employ a cellulosic compound such as Celluloid which is readily soluble in acetone.

Also .in the dressing is a suitable adhesive which serves as a'cohesion means between the separate layers of the dressing when initially applied. It also enhances the characteristics of the dressing or casting during and after setting and hardening when the same is completely applied. For this purpose I employ an estergum such as gum acacia or the like which is soluble in a highly volatile solvent such as carbon tetrachloride. This solvent has the further advantage of being non-inflammable and like acetone will not dissolve the filler to a substantial extent.

In order that a more uniform drying or evaporation of the carbon tetrachloride and acetone solvents may be obtained throughout the thickness of the applied dressing I employ a vegetable oil, such as castor oil. The castor oil may also be dissolved in a highly volatile solvent, such as' *Qnemethod that -I have'employed to prepare "my-novel-surg'icalf dressing is as follows: First, I prepare my filler fiourand if wood is used, I subare volatilized or otherwise removed by heat. A more cellular structure is thus prepared. This heat treatment is optional. Thereafter in a.- container I add the wood flour, Celluloid, gum acacia, castor oil, and calcium chloride inthe amounts hereinbei'ore indicated. These substances may be intimately mixed with each other and I prefer to employ relatively s'mallparticles of the solid constituents. In another container I place the heretofore set forth amounts of acetone, carbon tetrachloride and absolute ethyl alcohol. These 11 1- uids are stirred and then poured into the first Q mentioned container which is now covered to render the same substantially hermetically sealed. The entire mix may be stirred or agitated while the container is so sealed. After the solutes of Celluloid, gum acacia and castor oil have been substantially completely dissolved, with the wood flour being substantially uniformly distributed throughout this solution, the composition is ready to be placed on the base or carrier.

This composition may be forced through a pair.

of parallel closely spaced fan shaped nozzles. Each nozzle has an orifice of a length equal to or V j the speed of the composition extrusion being synchronized. so that a layer of said composition about 1 millimeter thick is applied to each side of the fabric. Close to said'nozzles are a pair of set press rollswhich press said plastic composition into said fabric. with the finished combi- .nation beingabout 2,millimete'rs thick. Immediately thereafter the dressing is packed in containers which are quickly hermetically sealed.

. The dressing is now ready for use and may be applied bywinding the same around the fracture. After the proper number of layers are wound thereabout, the fractured memberis fluoroscoped and is reduced while under the influence of the fiuoroscope. The volatile constituents of alcohol, carbon tetrachloride and acetone have evaporated in parts from the applied dressing during this operation. However, the dressing does not set until after about 30 minutes and will harden in about six hours. If for any purpose it is desired to hasten the hardening process this can be done by placing the dressed member under a lamp or other type of baking apparatus.

' The hardened dressing now consists essentially of the fabric, Celluloid, gum acacia, castor oil and calcium chloride because substantially all of the solvents have evaporated therefrom and now there is a substantially uniform light weight X-ray transparent cast or dressing protecting the reduced fracture.

v In the event it is desired to provide a window in the cast or dressing, as sometimes happens when a wound is covered thereby, a solution of absolute ethyl alcohol, acetone and carbon tetrachloride applied to the selected area will so soften cast may be quickly and easily removed at the appointed time.

Although I have described my invention with particularity, it is to be limited only by the prior art V/ I I whaus'cmmeu:

1. A relatively high x-ray transparentcal dressing comprising the combination of a fabric and a plastic composition, said plastic composition comprising a tiller having a high transparency factor to X-rays, a solution whose solute contains a binder for said filler, an adhesive'tor cohesion when two layers of said dressing are contiguousand means comprising a vegetable oil for promoting uniform drying throughout the thicknessof said dressing when applied. the solvent of said solution being volatile, said filler be- 10 ing substantially insolvent in said solvent.

WALTER DAHMEN. 

